Combined appendiceal goblet cell adenocarcinoma and low grade appendiceal mucinous neoplasm: a case report

Appendiceal goblet cell adenocarcinomas (GCA) are rare entities with a distinctive composition of goblet, paneth and neuroendocrine cells. Cases combined or collision GCAs other appendiceal tumours exist in the literature, only few publications describing GCA low-grade mucinous neoplasm (LAMN). A 73-year-old female underwent right hemicolectomy following an orifice polypectomy showing adenocarcinoma. Histological examination revealed LAMN at orifice, remaining mucosa. By immunohistochemistry, showed CK20, synaptophysin chromogranin reactivity. Grading was performed using WHO-recommended three-tiered system based on proportion low high-grade morphological features. Current views biology revolve around unitary hypothesis neoplasia arising from pluripotent progenitor cell. This is supported by observation varied components primary metastatic disease sites, shared expression several differentiation markers among neoplasms. Genomic studies have shown that neoplasms acquire different mutations during tumourigenesis culminating distinct mutational profiles. Prospective into GCA-specific optimal treatment regimens lacking, current strategies been extrapolated those colon adenocarcinomas, despite having pathological molecular signatures.